The Clinical Value Of Neutrophil-to-Lymphocyte Ratio And Platelet-to-Lymphocyte Ratio In Assessment Of Cardiac Function And Prognosis In Elderly Patients With Chronic Heart Failure

Objective Explore the clinical value of neutrophil to lymphocyte ratio(NLR)and platelet to lymphocyte ratio(PLR)in diagnosis,cardiac function classification and prognosis assessment of the elderly patients with chronic heart failure.Methods A total of 164 patients older than 65 with chronic heart failure who were hospitalized in cardiovascular department of the First Affiliated Hospital of Soochow University from March 2013 to March 2016 were selected to the study.Divided into three groups according to cardiac function:NYHA ? grade 44 cases,NYHA ? grade 62 cases,NYHA ? 58 cases.At the same time,65 cases of non-heart failure control group from the physical examination center in this hospital were selected.Basic information,Blood routine(NEU ? LYM ?PLT et al),NT-proBNP,hs-CRP and echocardiography related indicators of these participants were recorded.Figure out these participants' NLR and PLR.The differences between the four groups were compared and the correlation analysis was made.In addition,All elderly CHF patients who clinically improved with treatment were followed up after discharge.The data about death and re-hospitalization were gathered.For multivariate analysis to evaluate the effects of independent parameters on the presence of terminal events in elderly CHF patients,we performed logistic regression analysis.Receiver operating characteristic(ROC)analysis was used to assess the ability of the NLR and the PLR to predict the presence of CHF and terminal events.Results Compared with the control group,the levels of NLR and PLR in elderly CHF patients were significantly increased.At the same time,in elderly CHF patients,the levels of NLR,PLR,NT-proBNP and hs-CRP were increased with cardiac functional grading raised,but the levels of LVEF decreased,and the differences were statistically significant(P < 0.001).Pearson correlation analysis showed that the NLR was positivelycorrelated with NT-proBNP and hs-CRP(P <0.01),and the NLR was negatively correlated with LVEF(P <0.01).The PLR was positively correlated with NT-proBNP(P <0.01).Multivariate logistic regression analysis showed that high level NLR was an independent risk factor for the occurrence of terminal events in elderly CHF patients(P <0.001).After ROC analysis,the best cut-off value of the NLR to predict the presence of CHF was 2.44 with 80.5% sensitivity and 73.8% specificity(AUC: 0.844,P < 0.001),and the best cut-off value of the PLR was 114.45 with 70.1% sensitivity and 53.8% specificity(AUC: 0.665,P< 0.001).In addition,the best cut-off value of the NLR to predict the occurrence of terminal events was 3.79 with 74.0% sensitivity and 81.3% specificity(AUC: 0.855,P <0.001),and the best cut-off value of PLR was 151.47 with 67.1% sensitivity and specificity74.7%(AUC: 0.740,P < 0.001).Conclusion The levels of NLR and PLR in elderly CHF patients are significantly higher than them in the control group.At the same time,the levels of NLR and PLR are closely related to the severity of the elderly CHF patients,and have a certain clinical value in evaluating the prognosis of the elderly CHF patients.